23 Signs and Symptoms of Vitamin B3 Deficiency

Vitamin B3 deficiency leads to serious health consequences such as cognitive decline, low energy, depression, and other mental disorders. Niacin, or vitamin B3, is crucial to human health mainly because it is a coenzyme. In fact, close to 400 enzymes depend on it for their optimum activity. 

Hence, it is crucial to know what causes vitamin B3 deficiency, the symptoms to look out for and learn some effective preventive measures as well. Read on and find out!

Vitamin B3 is also known as niacin. Niacin or nicotinic acid is one of the 8 known types of vitamin B. Vitamin B3 deficiency or Niacin deficiency occurs when the body cannot absorb the vitamin or gets little of it.

In fact, the deficiency extends up to the body’s inability to absorb tryptophan, which is the amino acid precursor of niacin.

Below are some of the functions of vitamin B3:

• Niacin or nicotinic acid helps to keep the nervous system working properly
• Further, it helps the body make sex-related hormones and stress-related hormones
• It helps to improve circulation and maintain cholesterol levels
• Moreover, it also helps to break down fats and proteins
• Vitamin B3 helps to convert carbohydrates into glucose

There are two types of vitamin B3 deficiency diseases:

Primary Pellagra

Primary pellagra occurs when a diet is low in niacin, putting individuals at risk due to insufficient intake of this essential nutrient. When a diet is low in niacin, the person is at risk for primary pellagra. For example, those whose diet includes maize as a staple are at higher risk for developing primary pellagra.

Secondary Pellagra

A person who cannot absorb vitamin B3 despite having a diet rich in vitamin B3 is at risk for secondary pellagra.

The persons who are at risk for vitamin B3 deficiency are:

• Alcoholism can cause a deficiency of niacin because of malnutrition.
• Other risk factors of secondary pellagra are malnutrition, Crohn’s disease, anorexia, HIV, Hartnup disease, dialysis, drugs for tuberculosis, carcinoid syndrome.

Vitamin B3 deficiency, known as niacin deficiency, is relatively uncommon in developed countries due to the widespread availability of niacin-rich foods and fortified products. However, it can still occur in certain populations, particularly those with poor dietary intake, alcoholism, or certain medical conditions that interfere with nutrient absorption. 

The risk of deficiency is higher in developing countries, where diets may lack diversity and rely heavily on staple foods like maize, which is low in niacin.

A deficiency in this important nutrient can lead to various health issues, such as pellagra, characterised by dermatitis, diarrhoea, and dementia. The most common vitamin B3 deficiency causes are as follows:

Diagnosing vitamin B3 deficiency involves a combination of clinical evaluation, medical history, and laboratory tests. Here are some key methods used in the diagnosis:

Clinical Evaluation

Physicians look for physical symptoms such as dermatitis, diarrhoea, and dementia, classic indicators of severe niacin deficiency. A thorough physical examination helps identify these symptoms and assess their severity.

Medical History

Reviewing the patient's dietary habits and underlying medical conditions is essential. Information about alcohol consumption, chronic illnesses, and the use of certain medications can provide clues about the potential causes.

Blood Tests

Measuring the levels of niacin and its metabolites in the blood can help confirm a deficiency. Low levels of niacin or its active form, NAD (nicotinamide adenine dinucleotide), can indicate insufficient intake or absorption.

Urine Tests

Assessing the excretion levels of niacin metabolites in the urine can provide additional information about the body's niacin status. Low urinary excretion of these metabolites suggests a deficiency.

Dietary Assessment

Evaluating the patient's diet for niacin-rich foods, such as meats, fish, and whole grains, can help determine if dietary intake is adequate. This assessment helps identify potential nutritional gaps that contribute to the deficiency.

Vitamin B3, or niacin, is vital for energy production, DNA repair, and maintaining healthy skin and nerves. Incorporating niacin-rich foods into your diet can help prevent and overcome deficiency, ensuring your body functions optimally.

The daily recommended intake of vitamin B3 varies depending on the age and gender.  Infants need 2-4 mg, young children (1-3 years) require 6 mg, and older children (4-8 years) need 8 mg. Pre-adolescent boys and girls (9-13 years) should get 12 mg, while teenage boys (14-18 years) need 16 mg and teenage girls need 14 mg. 

Adult men should consume 16 mg daily, and adult women need 14 mg. Pregnant women require 18 mg, and breastfeeding women need 17 mg. Meeting these requirements through a balanced diet is essential for overall health and preventing deficiency-related issues.

Vitamin B3 is essential for maintaining overall health and well-being. Its deficiency can lead to several health issues, some of which can be severe if left untreated. Below are some of the key side effects associated with a lack of vitamin B3:

• Pellagra: The deficiency of vitamin B3, in the long run, can lead to pellagra. Pellagra is a severe disease that arises from the lack of vitamin B3. Some of the symptoms of pellagra are dementia, dermatitis, and diarrhoea.
• Skin Problems: Deficiency can cause various skin issues, including red, inflamed skin, rough and scaly patches, and a condition known as dermatitis.
• Digestive Issues: Lack of vitamin B3 can lead to digestive problems such as nausea, vomiting, abdominal pain, and severe diarrhoea.
• Mental Health Issues: Niacin deficiency is linked to mental health problems like depression, anxiety, and, in severe cases, dementia.
• Fatigue and Weakness: Insufficient vitamin B3 levels can result in chronic fatigue and general weakness, impacting daily activities and overall energy levels.
• Mouth Sores and Swollen Tongue: A noticeable side effect of vitamin B3 deficiency includes sores in the mouth and a swollen, bright red tongue.

Deficiency in vitamin B3 can lead to several health issues, ranging from mild symptoms to severe diseases. You may notice some of the symptoms of vitamin B3 deficiency diseases in mild form. However, when the deficiency increases, it often leads to pellagra, which is a disease caused due to deficiency of vitamin B3.

Hence, the deficiency of vitamin B3 causes these diseases

• Pellagra: This is the most severe disease associated with vitamin B3 deficiency. Pellagra is characterised by the "3Ds": dementia, dermatitis, and diarrhoea. It can be life-threatening if left untreated.
• Dementia: A serious condition marked by memory loss, confusion, and cognitive decline, often seen in severe cases of pellagra. Dementia impairs daily functioning and significantly reduces quality of life.
• Dermatitis: Inflammation and redness of the skin, often accompanied by a scaly rash, particularly in areas exposed to sunlight. This skin condition can be painful and prone to infections if not treated.
• Diarrhoea: Chronic diarrhoea is another hallmark of pellagra, leading to dehydration and further health complications. Persistent diarrhoea can also result in nutrient malabsorption and weight loss.
• Depression: Niacin deficiency can lead to mental health issues such as depression. Symptoms include persistent sadness, loss of interest in activities, and changes in appetite or sleep patterns.
• Fatigue: A lack of vitamin B3 can cause extreme tiredness and weakness. This condition makes it difficult to perform everyday tasks and can severely impact productivity and overall well-being.

Vitamin B3 deficiency can affect anyone, but certain groups are more vulnerable due to their lifestyle, health conditions, or dietary habits, such as:

• Individuals with Poor Dietary Intake: People who consume diets low in niacin-rich foods, such as meats, fish, and whole grains, are at higher risk of deficiency. This includes those following restrictive diets or with limited access to various foods.
• Chronic Alcoholics: Excessive alcohol consumption can interfere with the absorption of niacin and other nutrients, leading to deficiency. Alcoholics often have poor dietary habits, exacerbating the risk.
• People with Digestive Disorders: Conditions like Crohn's disease, ulcerative colitis, and celiac disease can impair nutrient absorption, increasing the likelihood of vitamin B3 deficiency.
• HIV/AIDS Patients: Individuals with HIV/AIDS may experience malabsorption of nutrients and have higher nutritional needs, putting them at greater risk for deficiencies, including niacin.
• Certain Medication Users: Long-term use of specific medications, such as isoniazid (used to treat tuberculosis) and certain anticonvulsants, can interfere with niacin metabolism and lead to deficiency.
• Malnourished Populations: A group of malnourished populations, i.e., people living in poverty or with limited food security, are at higher risk due to inadequate intake of essential nutrients, including vitamin B3.

If one can diagnose vitamin B3 deficiency quickly, it is easily treatable. However, sometimes vitamin B3 deficiency may be misdiagnosed as alcohol withdrawal symptoms for those who consume alcohol. This misdiagnosis can delay proper treatment and worsen the condition. Therefore, it is crucial to consult with your doctor before taking supplements. 

A professional diagnosis ensures the correct treatment and helps prevent potential complications. Early detection and proper medical guidance are key to managing vitamin B3 deficiency effectively.